Should we worry about meconium? A controlled study of neonatal outcome

Over a 7 month period 131 cases with intrapartum draining of meconium-stained liquor (MSL) were reviewed and the neonatal outcome compared to that of all deliveries during the same time. Mean Apgars were significantly lower and the proportion of neonates with poor Apgar scores was higher if thick meconium was present, but not for thin meconium. Prolonged labour was more common and associated with a particularly worse outcome in the MSL group. Caesarean sections were performed twice as frequently, failure to progress being the indication in more than half the cases. Close monitoring of labour in the presence of MSL (particularly thick MSL) is important to detect failure to progress and fetal distress early.